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Related Experiment Videos

Interhemispheric interactions analyzed by coherence during flexor spasms.

H Otsubo1, M Steinlin, A Shirasawa

  • 1Department of Neurology, The Hospital for Sick Children, University of Toronto, ON, Canada. hiroshi.otsubo@mailhub.sickkids.on.ca

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|April 22, 1999
PubMed
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Coherence analysis revealed the right hemisphere led in a 5-year-old boy with flexor spasms originating from a mesial temporal lesion. Surgical removal of the lesion resulted in sustained seizure freedom.

Area of Science:

  • Neuroscience
  • Epileptology
  • Clinical Electrophysiology

Background:

  • Epileptic flexor spasms in children often necessitate surgical intervention.
  • Identifying the precise origin of ictal discharges is crucial for successful epilepsy surgery.

Observation:

  • A 5-year-old boy with medically refractory flexor spasms underwent digital electroencephalography (EEG) with video-EEG telemetry.
  • Analysis focused on 10 spasms, revealing an interhemispheric time lag with secondary bilateral synchrony.

Findings:

  • Coherence analysis demonstrated that the right hemisphere led ictal generalized discharges by a mean of 17 ms.
  • Pathology confirmed a low-grade mixed glioma and cortical dysgenesis in the resected lesion.
  • The patient achieved 4 years of seizure freedom post-lesionectomy.

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Implications:

  • Coherence analysis can effectively identify leading hemisphere in focal epilepsy.
  • This technique aids in localizing the epileptogenic zone for surgical planning.
  • Early surgical intervention based on precise localization can lead to long-term seizure remission.